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Oberman K, Hovens I, de Haan J, Falcao-Salles J, van Leeuwen B, Schoemaker R. Acute pre-operative ibuprofen improves cognition in a rat model for postoperative cognitive dysfunction. J Neuroinflammation 2021; 18:156. [PMID: 34238316 PMCID: PMC8265047 DOI: 10.1186/s12974-021-02206-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/23/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Inflammation is considered a key factor in the development of postoperative cognitive dysfunction (POCD). Therefore, we hypothesized that pre-operative anti-inflammatory treatment with ibuprofen would inhibit POCD in our rat-model. METHODS Male Wistar rats of 3 or 23 months old received a single injection of ibuprofen (15 mg/kg i.p.) or were control handled before abdominal surgery. Timed blood and fecal samples were collected for analyses of inflammation markers and gut microbiome changes. Behavioral testing was performed from 9 to 14 days after surgery, in the open field, novel object- and novel location-recognition tests and Morris water maze. Neuroinflammation and neurogenesis were assessed by immune histochemistry after sacrifice on postoperative day 14. RESULTS Ibuprofen improved short-term spatial memory in the novel location recognition test, and increased hippocampal neurogenesis. However, these effects were associated with increased hippocampal microglia activity. Whereas plasma cytokine levels (IL1-β, IL6, IL10, and TNFα) were not significantly affected, VEGF levels increased and IFABP levels decreased after ibuprofen. Long-term memory in the Morris water maze was not significantly improved by ibuprofen. The gut microbiome was neither significantly affected by surgery nor by ibuprofen treatment. In general, effects in aged rats appeared similar to those in young rats, though less pronounced. CONCLUSION A single injection of ibuprofen before surgery improved hippocampus-associated short-term memory after surgery and increased neurogenesis. However, this favorable outcome seemed not attributable to inhibition of (neuro)inflammation. Potential contributions of intestinal and blood-brain barrier integrity need further investigation. Although less pronounced compared to young rats, effects in aged rats indicate that even elderly individuals could benefit from ibuprofen treatment.
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Affiliation(s)
- Klaske Oberman
- Department of Neurobiology, GELIFES, University of Groningen, Nijenborgh 7, 9747, AG, Groningen, The Netherlands
| | - Iris Hovens
- Department of Neurobiology, GELIFES, University of Groningen, Nijenborgh 7, 9747, AG, Groningen, The Netherlands
| | - Jacco de Haan
- Department of Medical Oncology, University Medical Center Groningen, Groningen, The Netherlands
| | - Joana Falcao-Salles
- Department of Microbial Ecology, GELIFES, University of Groningen, Groningen, The Netherlands
| | - Barbara van Leeuwen
- Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Regien Schoemaker
- Department of Neurobiology, GELIFES, University of Groningen, Nijenborgh 7, 9747, AG, Groningen, The Netherlands.
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Abstract
Human health is intimately linked to the ecology and diversity of the human microbiome. Together, the human organism and the human microbiome work as a complex super-organism throughout the human life cycle. Microbiome science provides direct evidence and substantiation of the fundamental principles of homeopathy, including holism, psychosomatics, direction of cure, the Law of Similars, individuality and susceptibility, minimum dose, and homeostasis. Whilst many conventional (allopathic) medical treatments irreversibly damage the ecology of the microbiome and trigger chronic immune dysfunction and inflammation, the future sustainability of the entire field of medicine depends on the ability to recognize these inconvenient biological truths and to embrace a safer approach based on this evidence. Fortunately, one of the oldest forms of clinically verifiable, evidence-based, and ecologically sustainable medicine, that does not harm the microbiome, already exists in the form of homeopathy.
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Affiliation(s)
- Ronald D Whitmont
- Department of Family and Community Medicine, New York Medical College, Rhinebeck, New York, United States
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Nielsen A, Tick H, Mao JJ, Hecht F. Academic Consortium for Integrative Medicine & Health Commentary to CMS; RE: National Coverage Analysis (NCA) Tracking Sheet for Acupuncture for Chronic Low Back Pain (CAG-00452N). Glob Adv Health Med 2019; 8:2164956119857648. [PMID: 31321149 PMCID: PMC6624915 DOI: 10.1177/2164956119857648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Arya Nielsen
- Department of Family Medicine & Community Health, Icahn
School of Medicine at Mount Sinai, New York, New York
| | - Heather Tick
- Department of Family Medicine, and Anesthesiology & Pain
Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Jun J. Mao
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Frederick Hecht
- Osher Center for Integrative Medicine, San Francisco,
California
| | - the Consortium Pain Task Force
- Department of Family Medicine & Community Health, Icahn
School of Medicine at Mount Sinai, New York, New York
- Department of Family Medicine, and Anesthesiology & Pain
Medicine, University of Washington School of Medicine, Seattle, Washington
- Memorial Sloan Kettering Cancer Center, New York, New York
- Osher Center for Integrative Medicine, San Francisco,
California
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Tick H, Nielsen A, Pelletier KR, Bonakdar R, Simmons S, Glick R, Ratner E, Lemmon RL, Wayne P, Zador V. Evidence-Based Nonpharmacologic Strategies for Comprehensive Pain Care: The Consortium Pain Task Force White Paper. Explore (NY) 2018; 14:177-211. [PMID: 29735382 DOI: 10.1016/j.explore.2018.02.001] [Citation(s) in RCA: 191] [Impact Index Per Article: 31.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 02/08/2018] [Indexed: 02/06/2023]
Abstract
Medical pain management is in crisis; from the pervasiveness of pain to inadequate pain treatment, from the escalation of prescription opioids to an epidemic in addiction, diversion and overdose deaths. The rising costs of pain care and managing adverse effects of that care have prompted action from state and federal agencies including the DOD, VHA, NIH, FDA and CDC. There is pressure for pain medicine to shift away from reliance on opioids, ineffective procedures and surgeries toward comprehensive pain management that includes evidence-based nonpharmacologic options. This White Paper details the historical context and magnitude of the current pain problem including individual, social and economic impacts as well as the challenges of pain management for patients and a healthcare workforce engaging prevalent strategies not entirely based in current evidence. Detailed here is the evidence-base for nonpharmacologic therapies effective in postsurgical pain with opioid sparing, acute non-surgical pain, cancer pain and chronic pain. Therapies reviewed include acupuncture therapy, massage therapy, osteopathic and chiropractic manipulation, meditative movement therapies Tai chi and yoga, mind body behavioral interventions, dietary components and self-care/self-efficacy strategies. Transforming the system of pain care to a responsive comprehensive model necessitates that options for treatment and collaborative care must be evidence-based and include effective nonpharmacologic strategies that have the advantage of reduced risks of adverse events and addiction liability. The evidence demands a call to action to increase awareness of effective nonpharmacologic treatments for pain, to train healthcare practitioners and administrators in the evidence base of effective nonpharmacologic practice, to advocate for policy initiatives that remedy system and reimbursement barriers to evidence-informed comprehensive pain care, and to promote ongoing research and dissemination of the role of effective nonpharmacologic treatments in pain, focused on the short- and long-term therapeutic and economic impact of comprehensive care practices.
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Affiliation(s)
- Heather Tick
- Departments of Family Medicine, Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA.
| | - Arya Nielsen
- Department of Family Medicine & Community Health, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Kenneth R Pelletier
- Department of Medicine, University of California School of Medicine, San Francisco, CA
| | - Robert Bonakdar
- Department of Pain Management, Scripps Center for Integrative Medicine, La Jolla, CA
| | | | - Ronald Glick
- Departments of Psychiatry and Physical Medicine and Rehabilitation, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Emily Ratner
- MedStar Health, Institute for Innovation, Integrative Medicine Initiatives, MedStar Montgomery Medical Center, Washington, DC
| | - Russell L Lemmon
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Peter Wayne
- Osher Center for Integrative Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Veronica Zador
- Beaumont Hospital Integrative Medicine, Oakland University William Beaumont School of Medicine, Rochester, MI
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Kim KW, Huh J, Lee SJ, Kim SP, Kim EB, Kim JC. Ulinastatin Supplementation During Human Amniotic Membrane Preservation to Improve its Viability. Curr Eye Res 2018; 43:621-629. [PMID: 29400632 DOI: 10.1080/02713683.2018.1434896] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
PURPOSE The amniotic membrane (AM) is the transparent innermost layer of the placenta and it facilitates rapid wound healing in a diversity of ocular surface disorders. However, extended periods of cryopreservation before use induce significant impairment of cell viability due to oxidative stresses and inflammatory responses. We investigated the effect of supplementing ulinastatin (ULI), a known serine protease inhibitor, and relevant mechanisms of action in AM preservation solution through the hypothermic continuum on inflammatory and apoptotic signals and viability of AM tissue. MATERIALS AND METHODS The expression of inflammatory signal factors, including high mobility group box 1 (HMGB1), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), receptor-interacting serine/threonine-protein kinase 3 (RIPK3) and anti-TNF-inducible gene 6 (TSG-6) which is a TNF-α-inducible anti-inflammatory protein, and the expression of apoptotic signal factors, including caspase (Cas)-9 and Cas-8, the initiators, and Cas-3, the executioner caspase and Bax were analyzed with or without ULI during hypothermic preservation of human AM. Subsequently, the actual viability of human AM tissue was verified with or without ULI supplementation throughout hypothermic continuum (both hypothermic- and cryopreservation). RESULTS Hypothermic AM preservation with ULI for 48 h resulted in downregulated expression of cold-inducible inflammatory factors, including HMGB1 and NF-κB, as well as RIPK3. In addition, ULI suppressed apoptotic signals related with Cas-9, Cas-8, and Cas-3 under hypothermic conditions. Furthermore, ULI supplementation during hypothermic- and cryopreservation of AM significantly enhanced viability of AM tissue and amniotic epithelial cells. CONCLUSIONS Supplementation of ULI during human AM preservation through the hypothermic continuum may be a feasible dual anti-inflammatory and anti-apoptotic strategy that enhances the viability of AM tissue.
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Affiliation(s)
- Kyoung Woo Kim
- a Graduate School of Chung-Ang University, College of Medicine , Seoul , Korea
| | - Jung Huh
- b Department of Ophthalmology , College of Medicine, Chung-Ang University Hospital , Seoul , Korea
| | - Soo Jin Lee
- b Department of Ophthalmology , College of Medicine, Chung-Ang University Hospital , Seoul , Korea
| | - Sung Po Kim
- c SK Bioland , Cheonan-si , Chungcheongnam-do , Korea
| | - Eung Bae Kim
- c SK Bioland , Cheonan-si , Chungcheongnam-do , Korea
| | - Jae Chan Kim
- b Department of Ophthalmology , College of Medicine, Chung-Ang University Hospital , Seoul , Korea
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Bellavite P, Marzotto M, Olioso D, Moratti E, Conforti A. High-dilution effects revisited. 2. Pharmacodynamic mechanisms. HOMEOPATHY 2014; 103:22-43. [DOI: 10.1016/j.homp.2013.08.002] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 08/12/2013] [Indexed: 11/30/2022]
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Adler UC. Low-grade inflammation in chronic diseases: an integrative pathophysiology anticipated by homeopathy? Med Hypotheses 2011; 76:622-6. [PMID: 21277692 DOI: 10.1016/j.mehy.2010.12.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Accepted: 12/24/2010] [Indexed: 12/20/2022]
Abstract
Pro-inflammatory cytokines and their chronic effect - low-grade inflammation - have been associated with diverse chronic conditions. Nonsteroidal anti-inflammatory drugs (NSAIDs) were recently proposed as a treatment strategy. Samuel Hahnemann, the founder of homeopathy, had already hypothesized a systemic and progressive disorder as the cause of many chronic diseases - the Psora theory. He also advised of the consequences of palliative use for chronic diseases, as a contrary effect of the "of the life-preserving principle" could worsen the course of those diseases. The hypotheses presented here are that the main aspects of Hahnemann's Psora theory are supported by current data on the role of pro-inflammatory cytokines and that the use of NSAIDs to treat chronic low-grade inflammation can produce a contrary, rebound effect, as anticipated by Hahnemann. By diverting from the "palliative action-rebound effect" course, not only homeopathy but integrative medicine could provide different approaches to the treatment of low-grade chronic inflammation. Studies assessing inflammatory markers in chronic integrative treatments are recommended.
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Affiliation(s)
- Ubiratan Cardinalli Adler
- Homeopathy Graduation Program, Faculdade de Medicina de Jundiaí, Av. Francisco Telles, 250, Jundiai, 13202-550 São Paulo, Brazil.
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Bellavite P, Ortolani R, Pontarollo F, Pitari G, Conforti A. Immunology and homeopathy. 5. The rationale of the 'Simile'. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2007; 4:149-63. [PMID: 17549232 PMCID: PMC1876612 DOI: 10.1093/ecam/nel117] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2006] [Accepted: 01/04/2007] [Indexed: 12/20/2022]
Abstract
The foundation of homeopathic medicine is the 'Similia Principle', also known as the 'Principle of Similarity' or also as the 'Simile', which reflects the inversion of pharmacological effects in healthy subjects as compared with sick ones. This article describes the inversion of effects, a widespread medical phenomenon, through three possible mechanisms: non-linearity of dose-response relationship, different initial pathophysiological states of the organism, and pharmacodynamics of body response to the medicine. Based on the systemic networks which play an important role in response to stress, a unitary and general model is designed: homeopathic medicines could interact with sensitive (primed) regulation systems through complex information, which simulate the disorders of natural disease. Reorganization of regulation systems, through a coherent response to the medicine, could pave the way to the healing of the cellular, tissue and neuro-immuno-endocrine homeodynamics. Preliminary evidence is suggesting that even ultra-low doses and high-dilutions of drugs may incorporate structural or frequency information and interact with chaotic dynamics and physical-electromagnetic levels of regulation. From the clinical standpoint, the 'simile' can be regarded as a heuristic principle, according to which the detailed knowledge of pathogenic effects of drugs, associated with careful analysis of signs and symptoms of the ill subject, could assist in identifying homeopathic remedies with high grade of specificity for the individual case.
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Affiliation(s)
- Paolo Bellavite
- Department of Scienze Morfologico-Biomediche, University of Verona, Piazza L. A. Scuro, Verona, Italy.
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Affiliation(s)
- Philip R Liebson
- Section of Cardiology, Rush Medical College, Rush University Medical Center, Chicago, IL 60612, USA.
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10
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Yun AJ. The intellectual lineage of paradoxical pharmacology strategy. Med Hypotheses 2006; 65:815. [PMID: 15990242 DOI: 10.1016/j.mehy.2005.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2005] [Accepted: 05/06/2005] [Indexed: 11/21/2022]
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Yun AJ, Lee PY, Doux JD. Paradoxical inflammation revisited: Muraglitazar and cardiovascular risk. Med Hypotheses 2006; 66:855. [PMID: 16337749 DOI: 10.1016/j.mehy.2005.10.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2005] [Accepted: 10/25/2005] [Indexed: 11/25/2022]
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Yun AJ, Lee PY, Doux JD. Salmeterol and paroxetine: more evidence for paradoxical medicine. Med Hypotheses 2005; 66:1037-8. [PMID: 16364562 DOI: 10.1016/j.mehy.2005.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2005] [Accepted: 11/08/2005] [Indexed: 11/27/2022]
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